Nasogastric Tube Maintenance

Introduction

  • This document serves as a checklist for evaluating competency in the skill of removing nasogastric and nasointestinal tubes.

  • It includes a step-by-step process, which needs to be completed satisfactorily to demonstrate proficiency.

Instructions

  • It is imperative to select Satisfactory (S) or Unsatisfactory (U) for each step, with additional comments as needed.

  • Relevant information such as assessment findings and pharmacological/nonpharmacological interventions must be documented in the client’s medical record.

Step-by-Step Checklist for Removing Nasogastric Tube

Initial Steps

  • Verify the medical prescription for removal of the nasogastric tube.

  • Provide privacy as needed.

  • Introduce yourself to the client.

  • Perform hand hygiene and put on appropriate Personal Protective Equipment (PPE) if indicated.

  • Verify client identification.

  • Determine whether the client has allergies.

  • Provide client education.

Engaging Fundamentals Checklist: Nutrition

Preparing to Remove the Tube

  • Raise the height of the bed.

  • Raise the head of the bed to 30 to 45 degrees.

  • Place towel or disposable pad across the client’s chest.

  • Offer tissues and emesis basin.

  • Put on clean gloves.

  • Ensure any wall suction tube is disconnected from the nasogastric tube.

  • Detach the nasogastric tube from the gown.

  • Remove the tape or holder from the top of the nose.

  • Flush the tube with 10 mL of water or 0.9% sodium chloride irrigation solution, or instill 30 to 50 mL of air through the tube.

Removing the Tube

  • Clamp or kink the tube between index finger and thumb.

  • Ask the client to take a deep breath and hold the breath.

  • Smoothly and steadily pull the tube to remove it with the dominant hand and collect the tube in a towel or disposable pad with the nondominant hand.

  • Check the tip for intactness.

  • Measure and record the amount of output in the container by the markings on the container.

  • Dispose of the tube and suction equipment per facility policy.

  • Remove and apply clean gloves.

  • Clean nares and provide oral hygiene.

  • Ensure that the client is in a safe position prior to leaving the room and has the call light within reach.

References

  • Taylor, C., Lynn, P., & Bartlett, J. (2019). Fundamentals of nursing (9th ed.). Philadelphia: Wolters Kluwer.

  • Perry, A.G., Potter, P.A., & Ostendorf, W.R. (2018). Clinical nursing skills & techniques (9th ed.). St. Louis, MO: Elsevier.